Inevitable cesarean myomectomy following delivery through posterior hysterotomy in a case of uterine torsion.

BACKGROUND

Torsion of the pregnant uterus at term is a very infrequent obstetric event. It is usually associated with the presence of myoma or congenital deformities. Maternal prognosis is good after surgical treatment; however, prenatal mortality is high.

CASE REPORT

We report a case of posterior low transverse hysterectomy in a case of uterine torsion at 38 weeks' gestation, due to a large myoma. At presentation, her cervix was unfavorable and cardiotocography showed spontaneous deceleration demanding delivery by cesarean section. Following delivery, it was realized that the incision had been made on the posterior wall of the uterus and that the uterus was axially rotated by 180 degrees. The mother recovered uneventfully and both mother and the baby were discharged on the fifth postoperative day.

CONCLUSION

Obstetricians must have uterine torsion in mind when performing a cesarean section in patients with myomas.